Severe Acute Respiratory Syndrome Coronavirus 2 Testing in Children in a Large Regional US Health System During the Coronavirus Disease 2019 Pandemic.
Severe Acute Respiratory Syndrome Coronavirus 2 Testing in Children in a Large Regional US Health System During the Coronavirus Disease 2019 Pandemic.
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DOI：
10.1097/inf.0000000000003024
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发表时间：
2021-03-01
期刊：
影响因子：
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通讯作者：
Murray TS
中科院分区：
文献类型：
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作者：
Peaper DR;Murdzek C;Oliveira CR;Murray TS
目的是评估2019年儿童冠状病毒病在整个大流行期间、学校重新开学前后在大型卫生系统中的检测模式。这是一项对南康涅狄格州以及纽约和罗德岛地区进行严重急性呼吸综合征冠状病毒2型检测的儿童的临床病毒学结果的横断面时间序列研究。收集的数据包括人口统计数据、住院情况、阳性检测百分比随时间的变化、持续阳性儿童的检测间隔和周期阈值。背景是耶鲁纽黑文卫生系统在康涅狄格州的4个地点拥有6家医院，在罗德岛有1家医院，在康涅狄格州、罗德岛和纽约有门诊地点。参与者包括23,137名18岁的儿童，他们在2019年在流动检测点、急诊科或耶鲁大学纽黑文卫生系统的住院病房进行了冠状病毒病检测。在所有检测中，3.2%为阳性。无论社区流行率如何，年龄较大的儿童始终占儿科阳性病例的较大比例。在大流行后期，当成人的流行率相对较低时，儿科病例的增加与儿童进行的更多检测有关，而不是与阳性率的增加相关。在学校重新开学后，没有发现积极趋势的显著变化。有症状和无症状的儿童无论年龄大小都有相似的周期阈值，一部分儿童表现出持续的病毒检测，有些持续长达6周。夏末记录的儿科病例增加的主要原因是儿童接受检测的机会增加。儿童的阳性百分率在开学后的前3周没有变化。一组儿童在最初感染后的几周内，在上呼吸道可检测到严重急性呼吸综合征冠状病毒2RNA。
The objective was to evaluate patterns of pediatric coronavirus disease 2019 testing in a large health system throughout the pandemic, before and after school reopening. This was a cross-sectional time-series study of clinical virology results from children tested for severe acute respiratory syndrome coronavirus 2 in Southern Connecticut and areas of New York and Rhode Island. Data collected include demographics, hospital admission, changes in percent positive tests over time, detection intervals in persistently positive children and cycle threshold values. The setting was the Yale New Haven Health System has 6 hospitals at 4 Connecticut locations, 1 hospital in Rhode Island and ambulatory locations in Connecticut, Rhode Island and New York. Participants included twenty-three–thousand one-hundred thirty-seven children ≤ 18 years of age, tested for coronavirus disease 2019 at an ambulatory testing site, the emergency department or on an inpatient unit within the Yale New Haven Health System. Among all tests, 3.2% were positive. Older children consistently made up the larger portion of positive pediatric cases, regardless of community prevalence. Increased pediatric cases later in the pandemic when prevalence in adults was relatively low correlates with a higher number of tests performed in children and not with an increased positivity rate. No significant changes in trends of positivity were detected after the reopening of schools. Symptomatic and asymptomatic children had similar cycle threshold values regardless of age, and a subset of children demonstrated persistent viral detection, some for as long as 6 weeks. An increase in pediatric cases documented in the late summer was predominately due to increased access to testing for children. The percent positivity in children did not change in the first 3 weeks after school opened. A subset of children has detectable severe acute respiratory syndrome coronavirus 2 RNA in the upper respiratory tract for weeks after the initial infection.